ch 02

I'll Stop Procrastinating When I Get Around to It

Chapter 2How to Save Those Pearly Whites

“I think, therefore I am” is the statement of an intellectual who underrates toothaches.—Milan Kundera.

The Tooth FairyLet’s look at proper dental hygiene as a

first step toward the good life, maybe not an exciting step, but certainly a hard one.

Now, my story started out pretty much like everyone else’s. I brushed most of the time, though not too thoroughly or correctly, mainly skimming over the crowns, rather than getting at the gum lines where the action is. And every time I visited the dentist’s office, the dental hygienist would give me hell about the sorry state of my gums. She always admired my teeth but felt nauseous when she saw my gums. And the hygienist would tell me that my only chance to save my chops was to floss every day. So I’d go home, full of guilt for my slothfulness and full of fear for my future; and I’d floss diligently — for the next three days. But gradually, my flossing would fall off to zilch. However, the day before my next trip to the dentist, I’d go through yards of floss, vainly trying to make up for opportunities lost. That cycle repeated itself for several years. Then a friend turned me on to a magic book.

The book was The Tooth Trip, an Oral Experience1, by Thomas McGuire DDS, a delightful little book, with a nice, informal style, and great cartoons, written just for us kids. It makes the dreary subject of dental hygiene almost fun. But what turned me on the most was this piece of information: No one should have tooth decay, yet 25,000,000 living Americans have lost their teeth. We should have all of our teeth when we die, but few Americans do.

You know, that really is a tragedy. And a major way we can prevent that tragedy is to floss every day. But most people don’t. For example only 5%

of the super-smart, super-conscientious, super-hardworking high-school students who apply for WMU’s National Merit Scholarship floss regularly.

Now, another factor in my history helped me along. For years, dentists and hygienists kept bemoaning the sad condition of my poor, old, sick gums. And I could tell there were problems too. Like when I bit down on an apple my gums started bleeding, a common, gross-out occurrence. Also, every time the hygienist cleaned my teeth there was so much blood, the office looked like a scene from Scream. And finally, my dentist said that maybe I should go to a periodontist who would no doubt put the knife

1 McGuire, T. (1972). The Tooth Trip: An Oral Experience. New York: Random House.

document.doc Chapter 2. 4/12/2023


to my gums, if I couldn’t get them under control with less obtrusive measures.

So all those factors combined to make me really want to floss. The hygienist, the dentist, the blood, and finally the book. As a result, I had a rule that stated a very important outcome: “Floss daily, or else! Or else you’re going to lose your teeth and suffer the indignity of the knife to boot.”

Still my flossing didn’t get much better. Maybe I’d keep my act together for five days after a visit to the dentist instead of three days, but that was about it.

Here was the problem. I knew I really didn’t have to floss every day. I could miss one day, and my dentist would never notice; he would never say, “Well I see by the plaque on your teeth that you flossed 175 days and goofed off once, on February 23.” No, one day wouldn’t have a noticeable effect. So why not make that one day today? After all, it is time to go to bed; and I’ve had a busy day. and I am very tired. What’s the difference if I floss tonight or wait just a few more hours and floss first thing tomorrow morning.

And when tomorrow morning becomes this morning, I’m already late for work, so I might as well wait until after dinner to floss, etc. periodontist’s knife, here I come.

Here’s another way to look at the problem: I have a certain level of dental health. I floss one time, and I have an infinitesimally2

better level of dental health. Well that marginal improvement in the health of my gums just isn’t enough to reward (technically to reinforce) my flossing, even though the behavior of flossing is.

Clearly a job for performance management. I need to manage my own behavior. There’s something I really want to do, but I’m not doing it. I need a little help. Well, help from performance management can come in three stages, and I always prefer to start with the simplest stage. The simplest is to state a clear-cut rule that you should follow. But I’d already tried that and failed. The clear-cut rule was, “Floss every day.” So then I move on to the next stage: Adding some sort of recording and feedback. My favorite form is to use a graph, though some people prefer to use a calendar, or

just a list of successes and failures on a sheet of paper, or the wall, or where ever.

2 in·fin·i·tes·i·mal (adjective) Immeasurably or incalculably minute (small). Don’t confuse infinitesimal with infinite. Infinite means real big, but infinitesimal means real small.



GraphingHere’s the way I set up a flossing graph:



The graph has the 52 weeks of the year along the horizontal axis and the 7 days of the week along the vertical axis. Now every day you floss, you add one more dot above that week. Suppose on week one, you flossed Monday, Tuesday, didn’t Wednesday, did Thursday and Friday, and then flaked out for the rest of the week. (My week starts Monday.) You flossed a total of four days, so you’d mark up four days like this:

You put a little dot above week one for each of your four successful days. Now, notice that you put your third dot across from day three, rather than day four, although you did your third flossing Thursday and not Wednesday. That’s because the vertical axis corresponds to the number of days you flossed, not to the specific days in the week. In other words, the 3 on the vertical axis means that’s the third day you flossed, not that it is Wednesday. This way you can look at your graph and tell right away how many days you flossed in each week.3

3 I have a complex system for keeping track of the days when you goofed off, but most people had too much trouble understanding it; and few people gave a damn what were their days of sin; and to tell you the truth, I’ve never found it too useful to keep track of the specific days I was off target. It usually does the trick just to know how many days I hit the mark each week; so I’ve bagged the complex system. If you’re curious, this complex system of keeping track of the specific missed days will probably be buried somewhere on my home page, http://vms.cc.wmich.edu/~malott/index.html. And as you’ll see in later chapters, you can more easily keep track of the specific days using a computer-generated stack-bar graph.



Now let’s look at three weeks worth of data:

Your graph shows that you flossed 4 times on week 1, 5 times on week 2, and 7 times on week 3. Congratulations.



At the end of each week, if you want to be really cool, draw a vertical line from the horizontal axis up to your top dot, so that you’ll have a nice bar graph to look at like this one:

Just for a little practice, why don’t you plot your hypothetical data for weeks 4, 5, and 6? On week 4, you missed Tuesday. Week 5, you missed Wednesday and Thursday. Week 6, was perfect. (Plot it on the preceding graph, and then draw the vertical lines through the data points for each week.)

And imagine, at the end of 52 weeks, you’ll have a whole year’s worth of data, your dental flossing autobiography. Just what you’d always wanted, right?

The beauty of the year-at-a-glance graph is that you graph each week separately. If you blew it this week, you can redeem yourself by doing better next week. You always have the chance to get a fresh start the following week.

Beyond Graphing: Adding a Consequence

Sometimes all you need is to give yourself a clear-cut rule, and you’ve solved your self-management problems. Other times things are a little tougher, and you need to add feedback, like the preceding graphs. But sometimes, even that isn’t enough and you need to add some sort of little consequence, either a reinforcer for doing what you’re trying to do or a penalty for failing to. And that’s the way it is with me and flossing. By themselves, the graphs help a lot but not quite enough. With just the charts, I can get my amount of flossing up to four or five days a week, but when I add a little penalty clause, I may miss only one or two days a month.



I suppose how elaborate you’re willing to make your self-management procedure depends on how important it is to get better control over your behavior. In the case of flossing, I felt it was important that I floss daily, so I was willing to set up a penalty procedure. And here’s how it works:

It’s simple, I have a friend to whom I pay $1 every time I fail to floss. Now it’s important that you’re in frequent contact with your friend — once a day ideally; once a week, minimally. And your flossing should be an agenda item to be mentioned at least once a week, if not daily. Otherwise, the whole thing will most likely fall apart, as you forget to pay for your sins and gradually learn that you can sin with impunity. You’ll find that you can’t rely on yourself to raise the subject spontaneously if you’ve let things slide for a day or two. And that’s probably the hardest thing to get working right in this whole self-management procedure — making sure your friend checks with you periodically.

Now there are two time frames at issue here. The one specified in the SD (Deadline) box of the preceding performance-management contingency is the deadline for my flossing; if I don’t floss by 12:00 a.m., midnight, in other words, before the day is over, I’ve lost $1. I won’t actually give the $1 to my performance manager at midnight. I’ll do that at our weekly meetings on Monday, when we review my performance for the previous week (I find it works well to run my performance management weeks from Monday through Sunday). Notice that I’ve written that I will lose $1 on Monday (the time when the consequence will occur) in the before and after boxes of the performance-management contingency. So, when diagramming contingencies and writing performance contracts, remember that there are two time frames, the deadline by which the behavior of interest must occur and the time when the consequence will occur. The deadline goes in the SD (Deadline) box above the performance-management contingency. The time when the consequence will occur goes in the before and after boxes of the performance-management contingency.

So how well did this self-management project work? Well, for instance, in 1981, I flossed almost every day. Unfortunately, performance management arrived on the scene too late to keep me away from the knife; I had my wisdom teeth removed and my gums trimmed. But now that I’ve kept up the flossing for the three years since my surgery, my dentist, periodontist and dental hygienist all continue to tell me my chops are tops. So, I’m happy.

You may ask, “Do I have to keep up this self-management procedure all of my life?” And the answer is that it depends. Consider the case of my own flossing. I found, when I stopped the penalties and the charting, I still flossed several times a week. That was much more often than before I tried self-management; but it was not as often as I wanted, not as often as when I had the charting and the penalties. And since it was important to me, I got the procedure going again. Then a dental researcher from the University of Michigan told me daily flossing was enough; so I switched from twice to once a day and have done pretty well with no performance management for quite a few years, especially as long as the rest of my morning rituals hold together. In a few other areas, I’ve been able to drop out the self-management procedures completely and still keep my act together fairly well. But in most areas I anticipate having to fight the procrastination devil the rest of my life.



Also, this whole thing may seem too Mickey-Mouse. If it’s something we care enough about, do we really need all this rigmarole? Well, let’s look at that in the next chapter.

Here’s a rookie mistake and an actual student example:Dr. Malott, Hi! How are you? You told me to send an email about my PM flossing contingency. I specified a goal of flossing five nights out of one week. If by Saturday or Sunday my goal has been met, I would get the opportunity to buy something for myself. If I haven't met the goal, I would have to wait until the following week to try again. This is where there might be a problem with staying motivated to floss. If I failed to floss the first two days, for example, I've already lost the opportunity to get the reinforcer at the end of the week. Therefore, who cares if I floss at all for the rest of the week? She’s right. What is keeping her flossing the rest of the rest of the week? Those competing contingencies are going to sneak right in and then there goes a whole week without flossing.Another idea would be to place a couple dollars into an envelope each time I floss and then use that money to buy something I want at the end of the week. Anyways, I think I might go floss my teeth now so I'll see you tomorrow!She’s definitely on the road to a good performance management contingency. When creating an effective PM contingency, it’s best to require daily performance and have a consequence for each instance of behavior rather than an all or nothing consequence for the whole week. That way the incentive is still there for the next time. So instead of having the opportunity to buy something at the end of the week for five nights worth of flossing, she should put a dollar in an envelope (or lose a dollar to a Performance Manager depending on what’s going to work best) every night she flosses (or fails to floss). She should also have a good Performance Manager with whom she checks in with on a regular basis and who is in charge of the consequence to keep up the integrity of the Self-Management Project.(Revised Summer 2008 by Rebecca Markovits & Dana Pellegrino)

Real DataP460, Winter, 2000

2 students floss daily.37 don’t.

The 3-Contingency ModelFor those of you who don’t already know,

the diagram you saw earlier on this page is the 3-Contingency Model of Performance Management. Don’t be frightened by the long, technical name. It’s much easier than it sounds. We’re talking about how to change behavior here, and we can’t even imagine doing it without the 3-Con Model. This model will make it easier for us to understand the behavior we’re looking at. First we start with the Ineffective Natural Contingency. This is nothing more than a description of what’s naturally happening. You know, the harsh reality of why our behaviors are messed up. These contingencies are ineffective because the outcomes are too small or too improbable.

Let’s try it out with the flossing example. What’s the natural outcome of one flossing session? What benefit is there for flossing once? Each time you floss, it (barely) improves your dental health. Check out how we diagram the contingency.

Why is this contingency ineffective and why doesn’t it get us flossing? The improvement is way too small to actually reinforce that one grueling session of flossing. Speaking of grueling, that leads us into another type of natural contingency. The Natural Competing Contingency. There are all kinds of things that interfere with what we should be doing. What interferes with flossing? Could it be the pain you experience when you floss for the first time this year? Check out a diagram of this one.



Can you think of any behaviors that might compete with flossing? How ‘bout any other behavior, like watching TV, playing on the internet, going to sleep? I’m sure we could diagram thousands of contingencies that show things we’d rather be doing than flossing.

Let’s move on to the second contingency in the 3-Con Model. It’s the effective, Performance-Management Contingency. So, we’re not behaving as we should. We design the P-M contingency to get our behaviors in line. So what is it that makes this contingency effective in controlling behavior? Probable and sizable outcomes. Now back to flossing. Check out the P-M contingency we’ve diagrammed below.

We’ve made the outcome for one instance of flossing probable (you’ll definitely avoid losing $1 to your money hungry performance manager) and sizable (you’re a poor college student and you hate to lose any cash). Notice the deadline for flossing in the SD box: Before 12:00am. The deadline tells us when we have to floss or else pay up. Also notice that in the before and after boxes we’ve included the time that the loss of money will occur, on Monday. So did you catch on that we have a delayed outcome here? The outcome follows the behavior by more than 60 seconds and that means our contingency is indirect-acting. The P-M contingency doesn’t always have to be indirect acting, but most likely it will be. If the outcome in an indirect-acting contingencv follows the behavior by more than 60 seconds, then that outcome doesn’t reinforce or punish the behavior. So what does reinforce or punish the behavior? To find out, we need to go one step further.

That step is the third and final contingency, the effective, Inferred Direct-Acting Contingency. The P-M contingency sets up a theoretical direct-acting contingency that directly controls the behavior. And once again, for flossing, here’s our inferred contingency.

The outcome is immediate. The fear is gone as soon as you floss.


ch 02

Documents

id floss

yards of floss

level of gumi floss

day wouldnt

busy day

dental hygienist

tooth trip

healthier gums